MDHHS Finalizes SB 31 Blood Testing Rules

The Michigan Department of Health and Human Services has announced the administrative rules to implement Public Acts 145 and 146 of 2023.  These are the children's blood lead testing requirements passed by the Legislature in 2023 as SB 31:

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2025/05/05/universal-testing

https://www.legislature.mi.gov/documents/2023-2024/publicact/pdf/2023-PA-0145.pdf

https://www.legislature.mi.gov/documents/2023-2024/publicact/pdf/2023-PA-0146.pdf

https://www.michigan.gov/mileadsafe/-/media/Project/Websites/mileadsafe/Memos-laws-and-policies/FinalRules.pdf

Michigan blood lead testing rules finalized; physicians now required to order testing for children at ages 12 months and 24 months
By Lynn Sutfin - May 05, 2025

LANSING, Mich. –To help prevent and address lead poisoning of Michigan children as soon as possible, laws requiring physicians provide blood lead testing to all young children in Michigan are now in effect.

In October 2023, Gov. Gretchen Whitmer signed two bills into law requiring blood lead testing for all Michigan children at ages 12 months and 24 months of age (Public Act 146 of 2023) and that these tests be recorded on the child’s immunization record (Public Act 145 of 2023). This age-based approach to blood lead testing requirements is commonly called “universal testing.”

The legislation also required the Michigan Department of Health and Human Services to create administrative rules to implement the bills. Those rules have been finalized and are in effect.

The rules require physicians to test or order a blood lead test for all children at ages 12 months and 24 months, and at other intervals based on lead exposure risk. If there is no record of these tests, children must receive a blood lead test between 24 months and 72 months of age.

“By ensuring Michigan children universally receive a blood lead test at a very young age, we can more quickly address the health risks associated with elevated blood lead levels, which will lead to healthier lives,” said Dr. Natasha Bagdasarian, chief medical executive. “Families can also be alerted to the need to identify and address any hazards in their home that could be causing elevated levels, such as paint, plumbing or soil.”

There is no safe level of lead in the blood. Children and fetuses are most at risk of dangerous health effects. Exposure to lead can cause problems with:

*   Learning.
*   Behavior.
*   Speech.
*   Hearing.
*   Growth rates.
*   Development of the nervous system.

A blood lead test measures the amount of lead in a person’s blood. Visit Blood Lead Testing to learn about the different types of tests and what it means to have an elevated blood lead level.

Universal blood lead testing will increase the number of children tested in the state. Children with elevated blood lead levels may qualify for nursing case management services with staff trained to visit with families at their homes to discuss ways to help lower blood lead levels.

Children with elevated blood lead levels may also qualify for services provided through the Lead Safe Home Program, which can help eligible families find and fix lead hazards. Eligibility for the program is based on Medicaid or household income status and home location. Eligible families must also submit a completed application.

Lead exposure can come from many sources including paint in homes built before 1978, dust, soil, drinking water from older plumbing, jobs or hobbies that involve lead and some imported goods. When a child has an elevated blood lead level (3.5 micrograms per deciliter or higher), the following should occur:

*   Identify the source of lead.
*   Stop the lead exposure.
*   Determine any other tests or follow-up that might be needed.
*   Blood lead testing is a preventive health service under the federal Affordable Care Act and must be covered without additional copayment or coinsurance charges.

It is important for parents and legal guardians of children under 6 years old to talk to their child’s health care provider about blood lead testing, especially if there is concern about lead exposure.

Families may opt out of universal blood lead testing requirements.

Visit Michigan.gov/MiLeadSafe for more information about lead hazards, blood lead testing and lead services.